外科理论与实践2023，Vol.28Issue(5)：454-462,9.DOI:10.16139/j.1007-9610.2023.05.11
ICU病人耐碳青霉烯类肺炎克雷伯菌血流感染的危险因素与预后分析(附81例报告)
Risk factors and prognosis of carbapenem-resistant Klebsiella pneumoniae bloodstream infection in ICU patients:a report of 81 cases
刘萌 1邱毓祯 1徐文 1戴赟麒 1谭若铭 1刘嘉琳 2顾飞飞 3陈尔真 4王晓丽 1瞿洪平1
作者信息
- 1. 上海交通大学医学院附属瑞金医院重症医学科,上海 200025
- 2. 上海交通大学医学院附属瑞金医院老年医学科,上海 200025
- 3. 上海交通大学医学院附属瑞金医院微生物科,上海 200025
- 4. 上海交通大学医学院附属瑞金医院急诊科,上海 200025
- 折叠
摘要
Abstract
Objective Comprehensive mortality risk analyses and therapeutic assessment in real-world practice are beneficial to guide individual treatment in patients with Carbapenem-resistant Klebsiella pneumoniae bloodstream infections(CRKP-BSI).Methods Retrospective analysis of the clinical characteristics of 81 CRKP-BSI patients in our intensive care unit from July 2016 to June 2020,to indentify the risk factors of death and treatment effects of different antibiotic regimens.Results In 81 CRKP-BSI cases,the majority source were from abdominal and respiratory,accounting for 56.79%(46 cases)and 22.22%(18 cases),respectively.The 28-day mortality and hospitalization mortality of CRKP-BSI were 54.32%(44 cases)and 65.43%(53 cases).Multivariate regression analysis suggested that biliary tract disease before admission(P=0.026)and increased SOFA score at the onset of BSI(P=0.006)were independent risk factors for 28-day mortality.There was no statistically significant difference in 28-day mortality between the groups of antibiotic treatment based on tigecycline(44 cases)and polymyxin B(26 cases)[56.82%(25/44)vs.57.69%(15/26),P=0.943].Patients were evaluated based on their age(≤65 years vs.>65 years),gender,body mass index(≤25 kg/m2 vs.>25 kg/m2),and APACHEⅡ score(≤20 vs.>20),the use of renal replacement therapy and mechanical ventilation,there was no difference in the mortality among each subgroup.Conclusions Biliary tract disease before admission and SOFA score were independent risk factors for 28-day mortality.There was no significant difference outcomes between tigecycline-and polymyxin B-based therapy.关键词
耐碳青霉烯类肺炎克雷伯菌/血流感染/重症病人Key words
Carbapenem-resistant Klebsiella pneumoniae/Bloodstream infection/Critically ill patient分类
医药卫生引用本文复制引用
刘萌,邱毓祯,徐文,戴赟麒,谭若铭,刘嘉琳,顾飞飞,陈尔真,王晓丽,瞿洪平..ICU病人耐碳青霉烯类肺炎克雷伯菌血流感染的危险因素与预后分析(附81例报告)[J].外科理论与实践,2023,28(5):454-462,9.
